Progressive neurological deficits after general anaesthesia in a horse

Abstract

An otherwise healthy eight-year-old Irish Sports Horse mare weighing 590 kg underwent general anaesthesia for bilateral tarsal arthroscopy and arthrotomy with subsequent removal of two osseous intra-articular fragments. The horse was positioned in dorsal recumbency, with the pelvic limbs stretched backwards. The anaesthetic was uneventful except for a brief period of hypertension and mild hypoxaemia. However, a bilateral pelvic limb paralysis became evident during recovery, while the thoracic limb function and mental state of the horse remained normal. Postanaesthetic myopathy and fractures were excluded early on in the investigation and repeated neurological examinations revealed initially intact nociception, withdrawal and cutaneous trunci reflexes in both pelvic limbs, as well as normal anal and tail tone. A bilateral femoral neuropathy was suspected at first. However, the horse’s neurological function progressively deteriorated over the following night, leading to a flaccid paralysis of both pelvic limbs and complete loss of withdrawal and cutaneous trunci reflexes, and anal and tail tone, suggesting a central lesion. A histopathological examination was consistent with postanaesthetic myelomalacia.

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